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Complete vs partial fundoplication in children with esophageal atresia

David N Levin1, Ivan R Diamond, Jacob C Langer

  • 1Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Canada M5G 1X8.

Journal of Pediatric Surgery
|May 28, 2011
PubMed

Insights

Partial fundoplication offers better long-term symptom and medication-free recovery than complete fundoplication in children with prior esophageal atresia repair. This finding aids surgical decision-making for improved patient outcomes.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Congenital Abnormalities

Background:

  • Esophageal atresia repair can lead to complications like gastroesophageal reflux.
  • Fundoplication is a common surgical procedure to manage reflux in these patients.
  • Comparing surgical techniques is crucial for optimizing outcomes.

Purpose of the Study:

  • To compare the effectiveness of partial versus complete fundoplication.
  • To evaluate outcomes in patients with a history of esophageal atresia repair.

Main Methods:

  • Retrospective review of 47 pediatric patients undergoing fundoplication after esophageal atresia repair.
  • Patients had at least one year of follow-up post-procedure.
  • Data collected included demographics, pre- and post-fundoplication symptoms, and reoperation rates.

Main Results:

  • No significant differences in post-fundoplication symptoms like vomiting or dysphagia between partial and complete fundoplication groups.
  • A significantly higher proportion of patients undergoing partial fundoplication achieved long-term symptom- and medication-free recovery (52% vs 13%).
  • Hiatus repair frequency differed significantly between groups (23% vs 69%).

Conclusions:

  • Partial fundoplication appears to be associated with a greater likelihood of successful long-term recovery.
  • This suggests partial fundoplication may be a preferred approach for symptom management in this patient population.
  • Further research could explore the mechanisms behind this difference in recovery rates.
Abstract

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